June 15, 2000
Genetics and Heredity, Meal Planning, Food and Diet
Question from Cairo, Egypt:
I have heard that one factor that can help us in determining the heredity in diabetes is the HLA DR type. If the parents has a HLA DR3 or 4 then the children will more likely develop diabetes. My diabetic boy friend and I went through these analyses and it turned that his HLA DR are 3 and 4; mine are 7 and 8. Can you please advise me what would be the likelihood that our children develop diabetes and if there is anything we can do to influence that? I also needed to know what tests or analysis that we can do to assist us in knowing the likelihood of inheriting diabetes to our kids.
Since my boy friend had diabetes 14 years ago he has been using diet food such as sugar, sweets and Cokes. Recently we heard that the sweetening element in the diet products “aspartame” is very debatable. It was said that it causes cancer and hastens the occurrence of diabetes complications. I also heard that the FDA refused it and that all products containing it were boycotted in the developing countries. How far is this true? If yes what should we do to make sure that the long years of aspartame consumption hasn’t affected my boyfriend’s health?
It is really not possible to give an exact figure for risk to children in individual unaffected cases because the development of clinical diabetes is significantly governed by some unknown environmental factor. In the case of your friend who has what I presume is autoimmune diabetes, the commonest form in childhood, the overall likelihood of any of his children developing this form of diabetes is about 6%.
Aspartame is approved by the FDA and is perfectly safe. It is in fact a combination of two normal amino acids. It is perfectly all right for diabetics to use it as a sweetener.
Additional comments from Dr. Marco Songini:
First of all, the positive predictive value of DR typing is heavily influenced by the presence of a family history for type 1 diabetes. Any son or daughter you’d have will carry a general risk for type 1 diabetes of 6-7% higher than the one of the general population. The strong allele combinations towards enhanced risk for type 1 diabetes are the ones of DR4 with DR8. The chances the offspring get these depend on the Mendelian segregation. Please remember that genes confer only the background risk and to develop diabetes an environmental factor is still needed. You can do nothing to influence the genetic risk and I strongly advice you no to ask for genetic/immune tests in your kids as they are still confined to research because we don’t have any therapeutical approach to prevent the disease anyhow.
There’s no worry regarding normal use of aspartame which is safe enough that our patients have been using over the last decade with no problems at all.